Discussion with Mrs. Bush and First Lady of Panama Vivian Fernandez Torrijos During Visit to the National Oncology Institute
National Oncology Institute Panama City, Panama

November 21, 2008

10:34 A.M. EST

Q All these patients in this room are patients that had surgery
--

MRS. BUSH: Have had already the surgery? Have they already had
it?

Q Yes. Some patients are still --

MRS. BUSH: In a --

Q -- for make the -- finally do the last reconstruction job, or
they are making some kind of procedure for good.

MRS. TORRIJOS: So they are breast cancer survivors and part of the
program.

Q When I -- told me about my cancer, I never feel a --
(inaudible) -- because I felt everybody that I spoke with can't.
(Laughter.) And tell him that, okay, He's good, very good, He's God,
but always has solution. I'm here, I'm happy.

MRS. TORRIJOS: And healthy.

MRS. BUSH: And healthy, good, that's great.

MRS. TORRIJOS: Good for you.

Q And pretty.

MRS. BUSH: Yes, that's right. (Laughter.)

Q More pretty. (Laughter.)

Q Hi, it's nice to meet you.

MRS. BUSH: Nice to meet you.

Q When I was found that I have breast cancer, I became so sad.
I thought about my children because they always associate it, the
cancer, with death. But I came to this hospital, and here I found that
they saved my life, but also they returned me the feeling of the -- you
know, they returned me my breast --

MRS. BUSH: The reconstruction --

MRS. TORRIJOS: Self-esteem.

Q Yes, and also -- but I now can feel like a complete woman.

MRS. BUSH: Great, that's so good.

Q Thank you.

MRS. TORRIJOS: Thank you for sharing your story.

Q Yes. Now I'm writing a book --

MRS. BUSH: Oh, good.

Q -- to tell other women, because we need to know that the only
chance that we have to --

MRS. BUSH: Survive.

Q -- survive or to -- the chance of -- to save our life and to
be a woman in complete is to go to the medical screenings and to get
medical attention soon.

MRS. BUSH: Sure, early, as early as possible. That's terrific
that you're going to help other women with your book.

Q Yes, I hope so.

MRS. TORRIJOS: Thank you. What about you?

Q I do not speak --

MRS. BUSH: No, speak Spanish.

Q (As translated) I am very happy to meet so many important
people, especially because this has been a good experience -- to be able
to put this message out to women here and in other countries about being
aware of doing timely self-examinations. And believe me, that's why I
am here today.

MRS. BUSH: Thank you. Mucho gusto. I mean, gracias -- muchas
gracias.

MRS. TORRIJOS: (As translated) Of course, very nice.

Q (As translated) I primarily want to thank God because at first
when I was 28 years old and I got cancer --

MRS. TORRIJOS: (As translated) Twenty-eight? Very young.

Q (As translated) -- at first I thought that I was going to die
because I did not have enough resources, and I'm really grateful to all
the people who work in this hospital because there are people who don't
have enough resources but they take care of us anyway and give us
treatment.

MRS. BUSH: Still treat you. That's good.

MRS. TORRIJOS: Do you remember --

MRS. BUSH: Yes, I heard your story today.

Q This is my magic man.

MRS. BUSH: Oh, good. It's the doctor that helped you.

Q Yes, this is the doctor.

Q He is my doctor, too.

MRS. BUSH: He is your doctor, too.

MRS. TORRIJOS: But it's very uplifting that you share your story
today. Very nice.

Q He's a very good doctor.

MRS. TORRIJOS: Are you still in treatment?

Q Yes.

MRS. TORRIJOS: (As translated) How many sessions --

Q (As translated) No, I'm taking pills now.

MRS. TORRIJOS: Okay. Taking the pills.

MRS. BUSH: She is, still? Oh, good.

MRS. TORRIJOS: Doctor, how many women do we have with breast
cancer a year in our hospital here?

Q Five-hundred a year in Panama.

MRS. TORRIJOS: In the whole country.

Q In the whole country. And in here we take care of 500 -- over
the 90 percent of the patients. Usually some patients have early
detection, so they can treat out of the hospital, but all the patients
with radiations and that need radiation, chemotherapy, I give them our
hospital, so -- in the country it's the second cause of death of women
here in Panama.

MRS. TORRIJOS: In Panama, of the cancers -- not only for women,
but men and women -- breast cancer is the most --

Q Mainly treatment for here for breast cancer --

MRS. TORRIJOS: But for other cancers like lung cancer and stomach
cancer and the rest of the areas where cancer affects -- breast cancer
is the most frequent, or no? Most patients --

MRS. BUSH: For women.

MRS. TORRIJOS: Women, yes.

Q Yes, for women, it's the leading cancer. Well, it shares the
first place with cervical cancer. Usually one year it's cervical, the
other year breast cancer. But the first cause here in Panama is the
prostate cancer.

MRS. BUSH: For men.

Q For -- no, for men or for female.

MRS. BUSH: Oh, really?

Q The population -- the first cause of cancer -- or led to
cancer is prostate cancer. It's a big problem.

MRS. BUSH: Oh, really?

MRS. TORRIJOS: Men do not like to --

MRS. BUSH: Sure, be tested.

Q It was -- I was working with some campaign about prostate
cancer three months ago. We have a very big campaign --

MRS. BUSH: Awareness.

Q Awareness. We are working in that because it's more difficult
for men --

MRS. BUSH: Sure, to be tested.

Q -- to be examined. We are working on that.

MRS. BUSH: Well, that's really good, because women have really
started to speak out about breast cancer, and it's important for men to
speak out, too, about cancers that affect men; to encourage men to be
tested.

Q You know, we are trying with the First Lady of Panama to
educate the population -- just not for women, but the family, all the
family.

MRS. BUSH: Yes, families.

Q The parents, the daughters, the whole family.

MRS. BUSH: That's right, because the whole family is affected,
whoever gets it.

Q The whole family. So we are trying, with support of the First
Lady --

MRS. TORRIJOS: We're trying to do these campaigns and speak to the
people, right? How old are you now?

Q (As translated) Thirty-one.

MRS. TORRIJOS: Thirty-one, she says.

MRS. BUSH: Thirty-one, she's thirty-one.

MRS. TORRIJOS: (As translated) Three years since --

MRS. BUSH: Oh, great.

MRS. TORRIJOS: Very good.

MRS. BUSH: Very young. (Laughter.)

MRS. TORRIJOS: (As translated) We should thank God, right?

Q -- we should be able to help other people.

MRS. TORRIJOS: (As translated) Doctor, anything you would like to
ask for or recommend or say?

Q We are really glad for the preoccupation of how the First Lady
of Panama for this diease.

MRS. BUSH: I know, that's been so great. It's really terrific.

Q And really we would like to have more help in some areas; in
fact the area of education for the personal use in all the areas, the --

MRS. TORRIJOS: We made an agreement with -- as a network -- with
different countries and the United States with M.D. Anderson.

MRS. BUSH: M.D. Anderson and Susan Komen.

Q This is wonderful for all the population in Panama. This will
be amazing for helping the people.

MRS. BUSH: Well, it would be great if we could really collaborate
on research on this so that we could end up with a cure.

Q Yes, this is one of the more important parts that we needed;
the research and the -- we have now the imitation of the information --

MRS. TORRIJOS: The resources.

Q -- and the research. This is something that -- one part that
we needed.

MRS. BUSH: Are there a lot of people who are going into medicine
in Panama, a lot of people training to be doctors?

Q Yes, the medical field, but not in the oncology area.

MRS. BUSH: Oh, really?

Q It's difficult because too many years --

MRS. BUSH: To study.

Q -- to study. And everywhere, not just Panama. It's a big
problem. We have to encourage young people, young doctors, to get into
that career.

MRS. TORRIJOS: I had no idea about that. The incidents of
oncologists --

Q Everywhere, not just in Panama.

MRS. TORRIJOS: I know, worldwide. And it's sad, too, especially
--

Q Maybe it's because if one heart -- (inaudible) -- then you'd
have to see people die, and that's something that many people don't like
to see that. They prefer to do other things, not something that people
don't survive. (Inaudible) -- is something that you really feel happy
about.

MRS. BUSH: Like your patients feel about you. (Laughter.)

Q Well, in fact, I have the -- (inaudible) -- part. I treat the
patient that survives and I -- that I make to recover the part that they
lost, and they really feel happy about this. It's not the other side,
the side of the people that die.